ABSTRACT
Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.
ABSTRACT
<p><b>BACKGROUND</b>This study was designed in an attempt to determine the influence of neoadjuvant chemotherapy on estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2), and Ki-67 expressions in patients with breast cancer.</p><p><b>METHODS</b>Pre- and post-neoadjuvant chemotherapy, paired-tumor specimens from 103 patients with breast cancer administrated with anthracycline or anthracycline combined taxane regimen were collected. Immunohistochemical staining for ER, PR, Her-2, and Ki-67 was performed by the DAKO EnVision method.</p><p><b>RESULTS</b>Among the 103 cases, five patients (4.9%) had a complete response (CR), 82 (79.6%) partial response (PR), 15 (14.6%) stable disease (SD), and one (0.9%) progressive disease (PD), yielding an overall response rate (CR + PR) of 84.5%. Nine patients achieved pathological CR. There was a significant decrease in the average index of Ki-67 postneoadjuvant chemotherapy, compared with that before chemotherapy (24.1% vs. 39.7%, P < 0.001). After neoadjuvant chemotherapy, the changes of Ki-67 in different subtypes of breast cancer were different (P < 0.001), and these changes correlated with response to neoadjuvant chemotherapy (P < 0.001). No significant changes in immunohistochemical expression were observed for ER, PR and Her-2.</p><p><b>CONCLUSIONS</b>Neoadjuvant chemotherapy apparently reduced Ki-67 index in primary breast carcinomas, but profiles for ER, PR and Her-2 were not significantly different before and after neoadjuvant chemotherapy. The change of Ki-67 correlated with molecular subtypes and response to neoadjuvant chemotherapy, suggesting that Ki-67 index was a surrogate marker to predict the treatment response of neoadjuvant chemotherapy.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Young Adult , Anthracyclines , Therapeutic Uses , Breast Neoplasms , Drug Therapy , Metabolism , Therapeutics , Bridged-Ring Compounds , Therapeutic Uses , Immunohistochemistry , In Vitro Techniques , Ki-67 Antigen , Metabolism , Neoadjuvant Therapy , Receptor, ErbB-2 , Metabolism , Receptors, Estrogen , Metabolism , Receptors, Progesterone , Metabolism , Taxoids , Therapeutic UsesABSTRACT
Objective:To search the marker of micrometastatic hepatocellular carcinoma (HCC).Methods:Peripheral blood samples were obtained from 65 patients with hepatocellular carcinoma,21 non HCC malignant tumors,22 chronic hepatitis B or cirrhosis,and 21 normal healthy volunteers.To identify hepatocellular carcinoma cells in peripheral blood, liver specific alpha fetoprotein(AFP)mRNA was amplified from total RNA extracted from whole blood by nested reverse transcription polymerase chain reaction (Nested RT PCR).Results:AFP mRNA was not detected in the normal healthy volunteers and patients with non HCC malignant tumors.The presence of AFP mRNA in patients with HCC(44/65,67.7%)was higher than those with chronic hepatitis B or cirrhosis(2/22,9.1%, P